{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T21:23:33Z","timestamp":1788816213711,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":236,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Health\u2010literate healthcare organizations (HLHOs) have been associated with improved clinical outcomes and quality of care for both patients and healthcare services, through the implementation of the \u201cTen Attributes of HLHOs\u201d which support individuals in navigating, understanding, and using health information and services. Nurses, in both clinical and managerial roles, are crucial in supporting HLHO initiatives. However, a high level of perceived workload may influence their engagement with health literacy\u2013related initiatives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess nurses\u2019 and nursing coordinators\u2019 perceptions of the implementation of measures aimed at achieving HLHO status and the relationship between HLHO, sociodemographic factors, and participants\u2019 perceived workload.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter, cross\u2010sectional study was conducted among nurses and nursing coordinators employed in four Italian facilities. An online questionnaire was used to collect participants\u2019 sociodemographic data, perceived workload, and perceptions of the implementation of the ten HLHO attributes using the HLHO\u201010 instrument.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 386 participants were included. The HLHO\u201010 final scores revealed moderate perceptions of the implementation of health literacy measures across participating centers (mean\u2009=\u20094.73 out of 7; SD\u2009=\u20091.93). Higher HLHO levels were significantly associated with lower perceptions of workload. Female nurses and nurses employed in critical care and emergency departments were less likely to report lower workload (all\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher HLHO levels were associated with lower perceived workload, while differences were observed according to gender and working area. These findings suggest that organizational and contextual factors may be related to workload perceptions and highlight areas for further investigation and potential organizational improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing Management<\/jats:title>\n                    <jats:p>Healthcare organizations should consider integrating HLHO principles into organizational policies and practices while supporting staff education and organizational development. Stronger implementation of HLHO principles may be associated with more favorable workload perceptions and staff well\u2010being. Nurse managers and nursing coordinators can play an important role in promoting OHL initiatives and fostering organizational environments that support both healthcare professionals and high\u2010quality patient care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/3119702","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:41:51Z","timestamp":1787726511000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Health\u2010Literate Healthcare Organization Attributes and Perceived Workload Among Nurses and Nursing Coordinators"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7185-4850","authenticated-orcid":false,"given":"Valentina","family":"Simonetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4958-2640","authenticated-orcid":false,"given":"Giulia","family":"Franceschini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3170-1857","authenticated-orcid":false,"given":"Chiara","family":"Lorini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5171-4308","authenticated-orcid":false,"given":"Guglielmo","family":"Bonaccorsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2255-4244","authenticated-orcid":false,"given":"Gloria","family":"D\u2019Angelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0242-0599","authenticated-orcid":false,"given":"Sonia","family":"Stante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5981-3682","authenticated-orcid":false,"given":"Claudia","family":"Mezzadri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4309-7311","authenticated-orcid":false,"given":"Martina","family":"Tesei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2736-1792","authenticated-orcid":false,"given":"Giancarlo","family":"Cicolini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3622-6370","authenticated-orcid":false,"given":"Dania","family":"Comparcini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_2_12_1_2","unstructured":"World Health Organization Regional Office for the Eastern Mediterranean Quality and Patient Safety Access to Health Services https:\/\/www.emro.who.int\/uhc-health-systems\/access-health-services\/patient-safety.html."},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.31478\/201206a"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.12028"},{"key":"e_1_2_12_4_2","volume-title":"Men and Women of the Corporation","author":"Kanter R. 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